Skin Cancer: What Everyone Needs To Know

By Dr. Jason K Rivers BSc, FRCPC

Many people consider skin cancer to be only a minor health concern, and for the most part, this is true. However, in North America today, someone dies from skin cancer every hour. This is truly unfortunate, because most skin cancers are preventable or at least curable when detected at an early stage.

With early detection and treatment, non-melanoma skin cancers - basal cell and squamous cell carcinoma - can be cured in over 99% of cases. So, by taking basic steps to protect your skin, you can prevent this most common form of cancer from developing into a serious and deadly disease.

What is skin cancer?

Skin cancer occurs when malignant cells are found in the outer layers of your skin, particularly to areas exposed to sunlight such as the face, neck, hands, and arms.

Top six causes of skin cancer

• How much time have you spent in the sun? Living in a year-round sunny environment increases your chances of skin damage
• Overexposure resulting in sunburn -- most people receive 25 per cent of their lifetime exposure to the sun by age 18
• Artificial sources of ultra violet radiation (sunlamps and tanning booths)
• Fair-skinned people with red or blond hair
• Abundance of moles or freckles
• Family history of skin cancer

How do I protect myself?

• Stay in the shade on sunny days and use a SPF-15 or higher sunscreen, even in the winter
• Cover your exposed skin, wear a hat and sunglasses
• Check moles every few monthly for changes in appearance and sensitivity
• See a dermatologist or your family doctor regularly if you are at risk for skin cancer

What is the treatment?

Depending on whether the cancer has spread deeper into the skin or to other places in the body, treatment will be determined by the type of skin cancer, the size and location of the tumor and your general health. Treatment is usually surgery, however chemotherapy, radiation therapy or immunotherapy (specifically targets the tumour) is also used for those who are not candidates for surgery.

Types of skin cancer:

• Most common form of skin cancer
• Lesions are generally seen on the head or neck in people 40 years or older
• Basal cell carcinoma appears as a small pearl-coloured bump, which will increase in size and may bleed easily.
• Basal cell carcinoma rarely results in death

• Develops in people 50 years and older on sun-damaged skin
• May developed from actinic keratosis, which appears as a red, scaly, raised patch
• Growths appear as flat and red, becoming scaly-raised mounds
• Squamous cell carcinoma is the most common form of non-melanoma cancer that can spread and stems from tumors on the ear, lip or in the setting of immune suppression (for example renal transplant patients)
• Treatment is usually surgical or at time radiation therapy

• Often occurs on the back of men and the legs of women
• Risk increases with age. The average age of detection is between 45-50 years old.
• Appears as a dark flat or raised area on the skin, featuring multiple colours with shades of brown, black and even white.
• Is often irregular in shape though it has well-defined borders
• Can spread (metastasize) to other parts of the body through the lymph system or the blood.

About the author:
Jason Rivers, MD, FRCPC is a Professor of Dermatology at the University of British Columbia. He qualified as a dermatologist in 1986, having trained in Ottawa, Canada and London, England. Subsequently, Dr. Rivers spent one year at the Skin and Cancer Unit at New York University and studied for two years in Australia where he was involved in melanoma research. Dr. Rivers served for seven years as National Director of the Canadian Dermatology Association's Sun Awareness Program, and also participated in Environment Canada's forum to develop the UV index. His current practice includes cutaneous oncology, general dermatology, laser, and cosmetic dermatology.